hi there,
it has been about 4 years for me (also in groin), i've known for about half the time it is HS. i have been to dermatologist offices who have done poor i&d's and have tried to get me to go on long term antibiotics. i went to my primary / gp and was referred to a couple of surgeons, one of whom had the guts to tackle the HS. i was pretty much told by the MD's not to really trust dermatologists with this condition, because they aren't going to take any definitive action, just throw medications down your gut which will eventually do internal damage.
HS is now thought to be auto immune, most patients with weeping wounds experience some kind of secondary infection but it is usually minor. i understand antibiotics for the secondary infections that can occur, however antibiotics do nothing for the root cause, if it's the immune system acting up and not foreign bacteria.
how is your diet? do you have any food allergies? i did an elimination diet after my first surgery this year and came to learn that my body has sensitivity to both gluten and the nightshade family of foods. i changed my diet and it really did help with overall pain and inflammation (also found out that gluten gives me headaches). it didn't go away, but it did lessen the effects. taking supplements like turmeric, zinc, and a few others helped too.
unfortunately HS is a complex bugger with no truly known cause. the only definitive action you can take is to get surgery, but you have to have a surgeon well versed in the subject.. any diseased tissue remaining after surgery will just act up again as soon as it can. that's where i'm at now. two surgeries this year that did not get the whole thing, so i'm back to square one, plus scars and hospital bills.
good luck. it's not easy. but you're not alone. sometimes it's better to just laugh through the tears, at the sheer absurdity of it all, and just do our best to live our lives as comfortably as possible.
stress makes it worse. stress actually triggers an immune response .. which can cause nasty flares in the disease .. i know it's so much easier said than done to tell a HS sufferer "just don't stress about it!" but it is very helpful if you can practice something like mindfulness, meditation, or even therapy as often as possible.
baths help.. epsom salt and some essential oils like tea tree.
you will be ok. clean up your diet, quit smoking if you do, take baths regularly, try to relax.. and do some research on surgeons in your region if it gets that bad.